HEALTH EDUCATION

EDUCATION
 Communication of information about knowledge, skills, and values of
the society to each succeeding generation
 To help acquire the intellect and practical methods to function in society
TEACHING
 Process of stimulating the brain, organizing the data, guiding and
managing
 Learning activities towards effecting desirable changes in behavior

LEARNING
 mental activity by means of which knowledge, skills, habit, attitudes,
ideas and appreciation are acquired, retained and utilized in the
progressive adaptation and modification of behavior
 “change in behavior” (change for the better)
 Unique, individualized, not directly observable
 We do not learn the same way as each other
 You have to give them a scenario; if they don’t change, this is what’s
going to happen

HEALTH EDUCATION
 process whereby learning situation and experiences are created with
and for the people so they may be influenced to change favorable their
undesirable attitude and knowledge for the improvement of personal,
family, and community health.
 Involves giving information and teaching individuals, and communities
how to better achieve health activities which raise an individual’s
awareness, giving the individual health knowledge required to enable
him or her to decide on a particular health action.
 It will still depend on the patient whether or not they will listen to us,
but we need to encourage and influence them which is why we need to
figure out ways to do that.
 Activities that seek to inform the individual on the nature and causes of
health/illness and individual’s personal level of rik associated with their
lifestyle behavior (Whitehead, 2004)
 We need to individualize how the patient processes information

ASPECTS OF HEALTH EDUCATION

1. INFORMATION
 provision of confirmation about health to people
2. COMMUNICATION

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 how information is provided or disseminated (in a level that
your patients will understand)

PURPOSE AND CATEGORIES

1. Promote health
 Primary
 For 1st years
2. Prevent disease
 secondary/preventive
 for 2nd years (when we know more about diseases)
3. Preserve health
 tertiary

HEALTH PROMOTION
 process of increasing the level of well-being and self-actualization of
a given individual or group
 Includes health education
 Identification and reduction of health risks
 Empowerment - let them be in charge of their health
 Advocacy - you have to practice what you preach
 Preventive health care
 Health policy development

HEALTH LITERACY
 implies the achievement of a level of knowledge, personal skills, and
confidence to take action to improve personal and community health by
changing personal lifestyles and living conditions.
 Means more than being able to read pamphlets and make appointments.
By improving people’s access to health info, and their capacity to sue it
effectively, health literacy is critical to empowerment.

PRINCIPLES OF HEALTH EDUCATION

1. Cooperative process – exchange of information between the nurse and
patient
2. Learning
3. Involves motivation, experience and change
4. Meet the needs, interests, and problems of the people affected
5. Basic function of the health provider.
6. Slow and continuous process.
7. Makes careful evaluation of the planning, organizing, and implementing
of all health education activity.

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 8. Achieve by doing – try to model good health behaviors
9. Takes place at home, school, hospital, clinics anywhere.
10. Considers the health status of the people affected.
11. Have faith in people’s ability – trust the patient that they will change
12. Uses supplies, aids and devices
13. Creative process
14. Helps people attain health by their own effort
15. Utilizes available community resources

PATIENT TEACHING
 one aspect of the teaching-learning process which ensures that the
responsibility for care is transferred safely to the patient

CONCEPTUAL FRAMEWORK OF HEALTH ED

DIMENSIONS/ELEMENTS OF THE T-L PROCESS
 Teaching Objectives and Learning Needs
o You have to find out what your patient needs to know/learn,
interests then tweak the way you present/teach to the patient
based on that
o Objectives need to be timely/relevant
 Teaching-learning process
o There is an exchange of information
o Get feedback from patient
 Instructional content
o Depends on the timeframe, learning needs, and learning
capabilities of the patient
 Teaching strategies
o We need to be flexible on out teaching strategies depending on
the patient’s capabilities
 External Conditions
o The things around the patient will have an effect on the
patient’s health
 Inter-Intra Personal Relationships
o Include the people in the patient’s lives
o Influence and motivate the people who take care of the patient
 Outcome of health education process
o Whatever you are teaching, was it achieved?

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OUTCOMES OF HEALTH EDUCATION PROCESS
1. COGNITION CHANGE
 knowledge or perception of a person or group
 how the patient thinks, changes
2. ATTITUDE CHANGE
 Beliefs, predisposition, intentions, and tendencies
 How you present yourself/react to a certain topic
 Example: you don’t like junk food because it’s unhealthy, but
you still eat it anyway
3. BEHAVIOR CHANGE
 individual/group practice
 the change will be more on the way that you move
 long-term change compared to attitude change
 Example: you don’t like junk food, so you stay away from eating
it

4 PROCESSES THAT DETERMINE THE EXTENT TO WHICH A PERSON MAY BE

PERSUADED TO CHANGE
 ATTENTION
o Be a role model to the patient
o Practice what you preach
 COMPREHENSION
o Does the patient understand you?
o Give them what they need to change and tell them why so they
can think about it
 ACCEPTANCE
o Give them a reason to change and accept
 RETENTION
o What the patient remembers from what was taught
o Repeat what was taught and conduct a follow up if they
remember something

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BARRIERS TO CHANGE
1. CULTURAL BARRIERS
 Example: aetas; they feel like they don’t deserve healthcare and
education
2. SOCIAL BARRIERS
 Examples: Prisoners that need healthcare are sent to hospitals
with handcuffs on and chained to the bedrail; and everyone can
see them like that
3. PSYCHOLOGICAL BARRIERS
 Example: A patient who was gay didn’t want to get tested for
HIV for the fear that his family will know. What he didn’t know
was that his family already knew about it.
 Sometimes it’s just within the person; the patient can be a
barrier for themselves
4. LANGUAGE DIFFICULTIES
 There are some patients wherein they might not understand the
dialect that we use

HISTORICAL FOUNDATIONS: PATIENT EDUCATION IN HEALTHCARE

1. FORMATIVE PERIOD: 1800s (BARLETT, 1986)
 Emergence of health professions
 Emphasis on patient-caregiver relationship
 Before this time, anyone in the healthcare team were just
known as healthcare people
 Surgery emerged – people started operating on people
(operating theatre where people can watch the operation)
 Nutrition = height and weight
 Nurses’ caps hold medications and pins
 Healthcare team working together
 Braille was invented for the blind to be able to read
 “Cold box” invention = refrigerator = prevented diarrhea and
gastrointestinal problems
 Surgeons decided to think about disinfection and antiseptics
o They found out that if they do not clean their patient
beforehand, they are more susceptible to infection
 Listerine was invented
o Louis Pasteur’s theory that invisible germs are the cause
of numerous infections inspires an English doctor name
Joseph Lister
o Lister becomes the first surgeon to perform an
operation in a chamber sterilized by pulverizing

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 o Lister publicly recognizes the work of two men working
to modernize surgical practices: Dr. Joseph Lawrence
and Robert Wood
 Patient-caregiver relationship developed; humanized care;
now takes care of every aspect: spiritual, mental, and
emotional, not just physical
 Sun disinfection = would place patients outside to disinfect
 Mother and child relationship: if you do not take care of the
mother, you lose two lives
 FIRST PHASE
o Health professions emerged
o Technological developments
o Emphasis on patient-caregiver relationship
o Spread of tuberculosis and other communicable
disease
 Responsibility for teaching has been recognized as an
important role of nurses
 Florence Nightingale devoted her career to teaching nurses,
doctors, and health officials about the importance of proper
conditions in hospitals and homes to improve the health of the
people
o Emphasized the need for nutrition, fresh air, exercise,
personal hygiene
o Advocated educational responsibilities of district public
health nurses and authored: Health Teaching in Towns
and Villages
o Advocated for school teaching of health rules as well as
health teaching in the home
2. 2ND PHASE: EARLY 1900s
 Public health nurses in the UK understood the importance of the
role of the nurse a a teacher in disease prevention and in
maintaining the health of society
 1918 – The national league of nursing education (NLNE) in the
US observed the importance of health teaching as a function
within the scope of nursing practice
 1938 – NLNE recognized nurses as agents for the promotion of
health and prevention of illness in all settings in which they
practiced
3. 3RD PHASE: AFTER WW2
 A time of significant scientific accomplishments and a profound
change in the delivery system

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  Late 1940s-1950s - described as a time when patient education
continued to occur as part of clinical encounters but was
overshadowed by the increasingly more technological
orientation of healthcare
 1953 – Veterans Administration issued a technical bulletin
called “Patient education and the hospital program” – identified
the nature and scope of patient education
 1950 – NLNE identified course content in nursing school
curricula to prepare nurses to assume the role as teachers of
others
4. 60s AND 70s
 Patient education: specific task
 Emphasis: educating individual patients
 Patient education became a specific task
 Educating individual patients rather than providing general
public health education patient education was a significant part
of AHA’s statement on a patient’s bill of rights
 The National League for Nursing (NLN) developed the first
certified nurse educator (CNE) Exam “to raise the visibility and
status of academic nurse educator role as an advanced
professional practice discipline with a defined practice setting”
 1970s – AHA (American Hospital association) developed the
patient’s bill of rights to be adopted by healthcare institutions
 Patient’s bill of rights – establishes guidelines to ensure that
patients receive complete and current information concerning
their diagnosis, treatment, and prognosis (future/outcome of
their illness/treatment) in terms they can reasonably
understand
o Always try to inform patients about this
 ANA (American nurses association) emphasized patient
teaching as a key element in qualification, functions, and
standards for nursing practice
5. 80s and 90s
 Disease prevention + health promotion
 Rise of popularity of national health education programs
 International Council of Nurses – endorsed the teaching role of
a nurse as an essential component of nursing care delivery
 1993 – The Joint Commission International established the
nursing standard for patient education to be adopted by
hospitals or health agencies to be accredited

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 o JCI seal is a symbol of prestige and quality hospital and
patient management
o Look for JCI hospitals in the future
 1995 – the Pew Health Professions commission published a
broad set of competencies it believed would mark the success
of the health professions in the 21st century
o Recommendation 1: States should be standardized and
understandable language for health professions
regulation and its functions to clearly describe them for
consumers, provider organizations, businesses and the
professions
o Recommendation 5: Boards should educate consumers
to assist them in obtaining the information necessary to
make decisions about practitioners and to improve the
board’s public accountability
Boards should teach the patients to assist them
in getting information about decision making in
terms of their health
 Provide clinically competent and coordinated care to the public
 Involve patients and their families in the decision-making
process regarding health interventions
 Provide clients with education and counseling on ethical issues
 Expand public access to effective care
o Example: vaccinations
 Ensure cost-effective and appropriate care for the consumer
 Provide for prevention of illness and promotion of healthy
lifestyle for all Americans
st
6. 21 century
 Teaching role emphasized
 Many competencies deal with nurses assuming a teaching role
 2006 – The institute for healthcare improvement (IHI)
announced the 5 million lives campaign to reduce the 15 million
incidents of medical harm that occurs in US hospitals each year
 IHI – focused on improving care deliveries, to reduce hospital
related issues
 SULLIVAN ALLIANCE – formed to recruit and educate staff
nurses to deliver culturally competent care to the public they
serve
o Objective: To increase the racial and cultural mix of
nursing faculty, students, students and staff who will be
culturally sensitive to the needs of their clients

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  Role of the nurse educator shifted from disease-oriented to prevention-
oriented approach
 The paradigm of health education has shifted from imparting
information to patient empowerment to use their potentials, abilities,
and resource
DOPE – Disease-oriented patient education
POPE – prevention-oriented patient education
HOPE – Health-oriented patient education

LEGAL BASIS
RA 9173 – Philippine Nursing Act of 2002
 Article VI Sec 28: As independent practitioners, nurses are primarily
responsible for the promotion of health and prevention of illness
o Provide health education. To individuals, families, and
communities
o Teach, guide, and supervise students in nursing. Education
programs including the administration of nursing services in
varied settings such as hospitals and clinics

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